U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration. Application Due Date: August 26, 2013

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1 U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Bureau of Health Professions Division of Nursing Division of Medicine and Dentistry Veterans to Nurses and Physician Assistants Workforce Program Announcement Type: New Announcement Number: HRSA Catalog of Federal Domestic Assistance (CFDA) No FUNDING OPPORTUNITY ANNOUNCEMENT Fiscal Year 2013 Application Due Date: August 26, 2013 Ensure your Grants.gov registration and passwords are current immediately! Deadline extensions are not granted for lack of registration. Registration may take up to one month to complete. Release Date: July 25, 2013 Issuance Date: July 25, 2013 NOTE: Changes made on 8/2 to funding preference language; see next page and page 32 Joan Wasserman, DrPH, RN Bureau of Health Professions Division of Nursing Phone: (301) Fax: (301) Title VII section 747(a) of the Public Health Service Act (42 U.S.C. 293k) as amended by section 5301 of the Patient Protection and Affordable Care Act (P.L ) and Title VIII, sections 831 of the Public Health Service Act, (42 U.S.C. 296p and 42 U.S.C. 296p-1), as amended and added by section 5309 of the Patient Protection and Affordable Care Act (Pub. L )

2 August 2 Revision to FOA The Funding Factors section (section V.2. page 32) was modified on August 2, The section previously stated: Applications receiving a statutory funding preference are placed in a more competitive position among applications that can be funded. Applications receiving more than one preference will be ranked by the number of funding preferences awarded first and subsequently by position above the twentieth percentile. The FOA has been amended so that each applicant can request only one funding preference, rather than multiple funding preferences. BHPr has determined that each of the qualification pathways associated with the funding preferences independently address the statutory and programmatic goals that the preferences aim to achieve. Therefore, no individual preference carries more programmatic significance than another. An entity that meets only one preference is as competitive as an applicant that meets multiple preferences. Consequently, BHPr has determined that the award of multiple funding preferences would not create a meaningful distinction among applicants. Therefore, the FOA is being amended such that only one statutory funding preference will be awarded for each application. This will ensure all applicants are able to apply for the funding preference on equal footing, while also achieving the statutory and programmatic goals. Based on the above rationale, the Funding Factors section (section V2. page 32) has been revised to state, Applicants can choose to apply for the statutory funding preference by demonstrating how they meet one of the qualification pathways described under PHS Act Section 791 or Section 805. Applications receiving a statutory funding preference are placed in a more competitive position among applications that can be funded. Funding preference requests must be submitted in Attachment 9 and must indicate whether the applicant is applying for the Section 791 Funding Preference or the Section 805 Funding Preference. If an applicant requests more than one funding preference, only the first preference addressed will be evaluated. Please note: the funding preference for Section 791 will be determined by HRSA program officials, and the funding preference for Section 805 will be determined by peer reviewers. HRSA i

3 EXECUTIVE SUMMARY The Health Resources and Services Administration (HRSA), Bureau of Health Professions (BHPr) announces a funding opportunity to support a cooperative agreement that will create a Veterans to Nurses and Physician Assistants Workforce Program (VNPA-WP) to create and/or expand opportunities for veterans with prior medical training to receive the education necessary to become civilian nurses and physician assistants. Applications must address educational pathways for veterans into nurse and/or nurse practitioner and physician assistant education. The VNPA-WP will provide unbiased, expert guidance to HRSA and the academic community on transitioning veterans with prior military health care training into undergraduate nursing and/or nurse practitioner and physician assistant educational programs. Many veterans are not prepared to directly enter the baccalaureate or graduate degree programs required to become a civilian nurse, nurse practitioner, or physician assistant. The VNPA-WP will address this obstacle by identifying, developing, disseminating, and analyzing educational pathways or career ladder programs that build upon veterans military training and experience and provide a series of educational opportunities that will help veterans achieve meaningful employment as a nurse or physician assistant. Under the collaborative direction of BHPr, the VNPA-WP will forge partnerships with key stakeholders to collectively develop new career ladder programs for veterans and provide infrastructure support for a range of activities to encourage adoption of the most efficient and effective programs. In addition, the VNPA-WP will work with HRSA s Veteran s Bachelor of Science Degree in Nursing (VBSN) program (HRSA ) recipients to identify solutions to common challenges experienced by the VSBN grantees. The VNPA-WP is part of a concerted effort to promote meaningful employment opportunities for veterans and their spouses. The goals of the BHPr workforce development programs supporting this announcement, the Nurse Education, Practice, and Quality Program (Title VIII, Section 831 of the Public Health Service Act) and the Primary Care Training and Enhancement Program (Title VII Section 747(a) of the Public Health Service Act), are to strengthen and enhance the capacity for nurse education, practice, quality, and retention to address the nursing workforce, and to plan, develop, and operate an education program to train physician assistants to practice in primary care settings. VNPA-WP applicants must demonstrate the capacity to partner with HRSA to: Provide resources and guidance to nursing and physician assistant education programs on assessing and translating veterans skills and experience into civilian academic credit; Prepare civilian faculty and administrators to respond to the unique academic needs of veterans; Develop and conduct qualitative and quantitative assessments of career ladder programs for veterans; Create partnerships with appropriate organizations within the wider nursing and physician assistant communities and with other Federal agencies, such as the Departments of Defense, Veterans Affairs, Labor, and Education, to assist in the development of effective veteran career ladder strategies; and Disseminate best practice models. HRSA i

4 The VNPA-WP will focus on six interdependent goals: 1. Provide unbiased, expert guidance to the health care community on issues related to undergraduate nursing, nurse practitioner and physician assistant career ladder programs for veterans; 2. Provide supporting evidence for defining specific competencies to translate prior military training and experience into academic credit; 3. Identify exemplary best-practice nursing and physician assistant career ladder models for veterans to serve as exemplars for schools interested in developing similar programs; 4. Prepare academic and practice faculty and preceptors to respond to the unique strengths and needs of veterans through curriculum development and ongoing quality improvement activities; 5. Collect, analyze, and disseminate data metrics to assess the effectiveness of best practice models for nursing and physician assistant career ladder programs for veterans; and 6. Coordinate VNPA-WP scholarly, evaluation and dissemination efforts to share innovative, evidence-based, best practice models to transition military veterans into undergraduate nursing, nurse practitioner and physician assistant career ladder programs. This program will be funded for a five (5) year project period with five one-year budget periods, from September 30, 2013 through September 29, Approximately $370,000 is expected to be available in Fiscal Year 2013 appropriations to fund one cooperative agreement. Applicants may apply for a ceiling of up to $370,000 per year, including direct and indirect costs. Under Title VII, A Medically Underserved Community (MUC) funding preference is available for applicants who meet the MUC preference requirements and rank above the 20 th percentile of applications recommended for approval. Under Title VIII, a funding preference is available for applicants with projects that will substantially benefit rural or underserved populations or help meet public health nursing needs in State or local health departments. An eligible applicant to the VNPA-WP will be an institution that has academic units that meet Schools of Nursing and Physician Assistant Education Program s accreditation requirements. The proposed activities, organizational capacity, budget, and letters of support should portray significant collaboration between and contributions from both nursing and physician assistant partners. More specifically, eligible cooperative agreement applicants must meet both Title VII and Title VIII eligibility requirements as follows: 1) Eligible entities under Title VIII Section 831 include a school of nursing, as defined in Section 801(2), a health care facility, or a partnership of such a school and facility; and 2) Eligible entities under Title VII Section 747(a) include an accredited public or nonprofit private hospital, accredited school of medicine or osteopathic medicine, accredited academically affiliated physician assistant training program, or a public or private nonprofit entity which the Secretary has determined is capable of carrying out such grant or contract. The application due date is August 26, Read the application guidelines and the full application carefully before submission to be certain that all required information is included. All required information must be included in the application at the time it is submitted or it will be deemed non-responsive and will not undergo review for potential funding. HRSA ii

5 A technical assistance webinar has been scheduled to help applicants understand, prepare and submit the cooperative agreement application. The webinar is scheduled for August 5, 2013 from 2:00 pm to 4:00pm EDT. Webinar information will be posted on the HRSA BHPr Division of Nursing website: as well as the Division of Medicine and Dentistry website: HRSA iii

6 Table of Contents I. FUNDING OPPORTUNITY DESCRIPTION PURPOSE BACKGROUND... 3 II. AWARD INFORMATION TYPE OF AWARD SUMMARY OF FUNDING... 5 III. ELIGIBILITY INFORMATION ELIGIBLE APPLICANTS COST SHARING/MATCHING OTHER... 8 IV. APPLICATION AND SUBMISSION INFORMATION ADDRESS TO REQUEST APPLICATION PACKAGE CONTENT AND FORM OF APPLICATION SUBMISSION i. Application Face Page ii. Table of Contents iii. Budget iv. Budget Justification v. Staffing Plan and Personnel Requirements vi. Assurances vii. Certifications viii. Project Abstract ix. Project Narrative x. Attachments SUBMISSION DATES AND TIMES INTERGOVERNMENTAL REVIEW FUNDING RESTRICTIONS OTHER SUBMISSION REQUIREMENTS V. APPLICATION REVIEW INFORMATION REVIEW CRITERIA REVIEW AND SELECTION PROCESS ANTICIPATED ANNOUNCEMENT AND AWARD DATES VI. AWARD ADMINISTRATION INFORMATION AWARD NOTICES ADMINISTRATIVE AND NATIONAL POLICY REQUIREMENTS REPORTING VII. AGENCY CONTACTS VIII. OTHER INFORMATION IX. TIPS FOR WRITING A STRONG APPLICATION HRSA

7 I. Funding Opportunity Description 1. Purpose This announcement solicits applications for the Veterans to Nurses and Physician Assistants Workforce Program. The purpose of the Veterans to Nurses and Physician Assistants Workforce Program (VNPA-WP) is to identify, develop, disseminate, and analyze educational pathways, or career ladder programs, that build upon veterans military training and experience and provide a series of educational opportunities required for civilian nursing and physician assistant careers. Applications must address educational pathways for veterans into nurse and/or nurse practitioner and physician assistant education. A career ladder program provides progressive stages of education and employment opportunity. It can begin with veterans with military health care experience, such as medics, corpsmen, and operating room technicians. Elements of a career ladder program may include emergency medical technician, paramedic, licensed practical nurse, baccalaureate studies for a BSN or that meet prerequisites for a physician assistant master s degree program. The ladder need not be linear. In fact, identifying similarities between educational programs will streamline processes and maximize flexibility and opportunities for veterans. The selected awardee will partner with HRSA and other Federal agencies, as facilitated by HRSA, and work with the wider civilian educational community to identify and disseminate successful strategies for transitioning veterans into civilian undergraduate nursing and/or nurse practitioner and physician assistant career ladder programs. HRSA intends to partner with other federal agencies, foundations, and public and private organizations to develop effective strategies that support training for veterans to enter high demand civilian health care careers. The VNPA-WP will be a principal collaborator supporting HRSA s efforts. Through innovative program coordination, scholarly activities, and analytic data collection efforts, the VNPA-WP will serve as a national hub to generate and disseminate best practice models for transitioning military veterans with prior medical training into undergraduate nursing, nurse practitioner and physician assistant career ladder programs. VNPA-WP applicants must demonstrate the capacity to partner with HRSA to: Provide resources and guidance to nursing and physician assistant education programs on assessing and translating veterans skills and experience into civilian academic credit; Prepare civilian faculty and administrators to respond to the unique academic needs of veterans; Develop and conduct qualitative and quantitative assessments of career ladder programs for veterans; Create partnerships with appropriate organizations within the wider nursing and physician assistant communities and with other Federal agencies, such as the Departments of Defense, Veterans Affairs, Labor, and Education, to assist in the development of effective veteran career ladder strategies; and Disseminate best practice models. HRSA

8 The VNPA-WP will focus on six interdependent goals: 1. Provide unbiased, expert guidance to the health care community on issues related to undergraduate nursing, nurse practitioner and physician assistant career ladder programs for veterans; 2. Provide supporting evidence for developing competencies to translate prior military training and experience into academic credit; 3. Identify exemplary best-practice nursing and physician assistant career ladder models for veterans to serve as exemplars for schools interested in developing similar programs; 4. Prepare academic and practice faculty and preceptors to respond to the unique needs of veterans through curriculum development and ongoing quality improvement activities; 5. Collect, analyze, and disseminate data metrics to assess the effectiveness of best practice models for nursing and physician assistant career ladder programs for veterans; and 6. Coordinate VNPA-WP scholarly, evaluation and dissemination efforts to share innovative, evidence-based, best practice models to transition military veterans into undergraduate nursing, nurse practitioner and physician assistant career ladder programs. 2. Background This program is authorized under Title VIII, Section 831 of the Public Health Service Act, (42 U.S.C. 296p and 42 U.S.C. 296p-1), as amended and added by Section 5309 of the Patient Protection and Affordable Care Act (Pub. L ), and Title VII Section 747(a) of the Public Health Service Act (42 U.S.C. 293k) as amended by Section 5301 of the Patient Protection and Affordable Care Act (P.L ). The U.S. Department of Veterans Affairs (VA) recognizes the need for veterans to become skilled in high demand careers and supports efforts to retrain veterans in fields where they are most likely to secure employment. The Veterans Retraining Assistance Program (VRAP) for unemployed veterans provides financial assistance for veterans to obtain certificates, diplomas or associates degrees in high demand careers, such as nursing, and runs through March 31, ,2 Registered nurses have long been considered a high growth occupation by the U.S Department of Labor with an expected growth rate of 26% (nearly 711,900 nursing positions) from 2010 to The urgency to build a robust nursing workforce has only intensified with the enactment of the Affordable Care Act of 2010, and a confluence of events e.g., the aging of the U.S. population (including the current nursing workforce) and an influx of veterans returning to civilian life (many of whom have war related injuries). The current shortages affect not only civilian but military-operated healthcare facilities as well. 2 Despite veterans role in founding the physician assistant profession, they represent a small 1 Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, Edition, Registered Nurses, on the Internet at (visited March 19, 2013). 2 Williams, Scott. A Win-Win-Partnership, VA Style. Minority Nurse.com. Springer Publishing Company, HRSA

9 proportion of practicing physician assistants. Only 5% of practicing physician assistants in 2010 had a military affiliation 3 and veterans accounted for only 2.72% of all admitted physician assistant students in Several barriers to recruiting and graduating veterans exist, including poor academic preparedness for graduate education, a lack of recruitment targeting veterans, and the rising cost of physician assistant education. 3 Veterans enrolled in physician assistant educational programs provide healthcare and life experience, maturity and motivation. 5 Strategies to help veterans enter physician assistant education should address veteran-specific recruitment and retention by developing curricula that assess and complement veterans unique strengths, medical training, and experience; and veteran-specific mentoring and support services. Many veterans receive training during their enlistment as health care providers in various capacities, and possess a wide range of medical skills. For some, this military training and experience may enable veterans to sit for vocational and practical nurse licensure examinations. For many others, their military training and experience gives them a valuable base on which to build by pursuing a BSN or a physician assistant degree. Programs and efforts to create veteran-friendly college campuses and curriculums are being developed nationwide. There is no consensus on what strategies work best to recruit, matriculate and graduate veterans from undergraduate nursing, nurse practitioner or physician assistant programs. With data collected from schools of nursing and physician assistant programs, relevant outcomes will be analyzed and shared with the health care community. Best practices will be determined based on the analysis and evaluation of relevant program outcomes and will be compiled as a guide for evidence-based, effective programs and methods that may be replicated by others. II. Award Information 1. Type of Award Funding will be provided in the form of a cooperative agreement. A cooperative agreement, as opposed to a grant, is an award instrument of financial assistance where substantial involvement is anticipated between HRSA and the recipient during performance of the contemplated project. In addition to the usual monitoring and technical assistance provided under the cooperative agreement, HRSA program responsibilities will include: 1) Participate in planning and development of all phases of this activity; 2) Participate in appropriate meetings and seminars conducted during the project period of the cooperative agreement; 3) Participate in periodic meetings and/or communications with the award recipient to review mutually agreed upon goals and objectives and to assess progress; 3 American Academy of Physician Assistants. (2011) AAPA Physician Assistant Census. Alexandria, VA 4 Physician Assistant Education Association Veteran Applicant CASPA data, Michaud, E., Jacques PF, Gianola FJ, Harbert K. Assessment of Admissions Policies for Veterans Corpsmen and Medics Applying to Physician Assistant Educational Programs. J. Physician Assistant Education. 2012; 23(1):4-12. HRSA

10 4) Assist in establishing and maintaining contacts with Federal agencies, professional organizations, HRSA grantees, and others as necessary to carry out the project; 5) Assist the VNPA-WP in establishing and maintaining an advisory panel; 6) Collaborate in the development of project data collection systems and procedures to ensure harmonized data across projects; 7) Review and approve all documents and products prior to submission for publication or public dissemination; 8) Facilitate the dissemination of information about project activities, 9) Facilitate effective communication and accountability to HRSA, key stakeholders, and the public regarding the project with special attention to program objectives; 10) Broker partnerships between the VNPA-WP and Federal partners, including the Departments of Defense, Veterans Affairs, Labor, and Education; and 11) Work with the VNPA-WP recipient to determine which components of the VNPA-WP can be replicated and disseminated in diverse populations and settings. The cooperative agreement recipient s responsibilities shall include the following: 1) Develop, implement, analyze, and disseminate activities that meet the six interdependent goals outlined in Section I of this funding opportunity announcement; 2) Provide the HRSA project officer(s) an opportunity to review project information and respond to recommendations prior to dissemination according to the agreed upon timeline; 3) Establish partnerships with organizations within the wider education community that may be relevant to the project s mission, such as Federal agencies, professional organizations, and other HRSA grantees; and 4) Convene an advisory panel that will provide expert recommendations regarding the program s direction and activities. The Project Director will nominate the members of the advisory panel. Changes in the composition of the advisory panel must be approved by the HRSA Co-Project Officers who will serve as ad hoc members of the advisory panel. The activities of the advisory panel will include: 1) Provide advice on data collection and evaluation of program objectives and report the overall progress of the program on an annual basis (or more frequently if necessary); 2) Make recommendations for establishing priorities; and 3) Make recommendations for identifying areas of new opportunities to accomplish VNPA-WP objectives more successfully. 2. Summary of Funding This program will provide funding for Federal fiscal years Approximately $370,000 is expected to be available annually to fund one (1) awardee. Applicants may apply for a ceiling amount of up to $370,000 per year. The project period is five (5) years. Funding beyond the first year is dependent on the availability of appropriated funds for the VNPA-WP in subsequent fiscal years, awardee satisfactory performance, and a decision that continued funding is in the best interest of the Federal Government. HRSA

11 III. Eligibility Information 1. Eligible Applicants 1) Eligible entities under Title VII Section 747(a) include an accredited public or nonprofit private hospital, school of medicine or osteopathic medicine, or academically affiliated physician assistant training program, or a public or private nonprofit entity which the Secretary has determined is capable of carrying out such grant or contract, and 2) Eligible entities under Title VIII Section 831 include a school of nursing, as defined in Section 801(2), a health care facility, or a partnership of such a school and facility. Only institutions holding both nursing and physician assistant education program accreditation are eligible to apply. Schools of Nursing Accreditation Requirements Schools of nursing providing nursing education and conferring degrees for participants must be accredited by a national nurse education accrediting agency or State approval agency recognized by the Secretary of the U.S. Department of Education. For FY 2013, these agencies include the Commission on Collegiate Nursing Education, National League for Nursing Accrediting Commission, Kansas Board of Nursing, Maryland Board of Nursing, Missouri Board of Nursing, Montana Board of Nursing, North Dakota Board of Nursing and New York Board of Nursing. All nursing schools associated with the project and conferring degrees must be accredited per PHS Act Title VIII, Section 831 and Section 801 authority. An official letter of accreditation from the appropriate national nurse education accrediting agency must be submitted under Attachment 1. No other forms of accreditation documentation (e.g., certificate of accreditation) will be accepted. The letter must be signed and dated by the accrediting agency. Where applicable, applications must provide information for provisional accreditation or reaccreditation status. This information should be clearly documented (i.e., last site visit date, pending date for final decision) in Attachment 1, submitted with this application. Accreditation for Newly Established Programs of Nursing: A new program of nursing that, by reason of an insufficient period of operation, is not, at the time of the submission of an application, eligible for accreditation by such a recognized body or bodies or State agency, shall be deemed accredited for the purposes of Title VII and Title VIII legislation if the Secretary of Education finds, after consultation with the appropriate recognized State approval or accrediting body or bodies, that there is reasonable assurance that the program will meet the accreditation standards of such body or bodies prior to the beginning of the academic year following the normal graduation date of students of the first entering class in such a program. Applicants must submit documentation with dates of accreditation (e.g., an accreditation letter from the accrediting agency) with the HRSA grant application as Attachment 1. HRSA

12 The following process must be followed for new nursing programs associated with the proposed project that are just beginning the accreditation process and wish to establish eligibility. The applicant must contact a national nursing accrediting or state approval body recognized by the Secretary of the Department of Education before requesting a reasonable assurance letter from the U.S. Department of Education. The nursing program will need to request a letter from the recognized accrediting agency describing the new program s progression toward accreditation by answering the six questions below: 1) Is this program actively pursuing accreditation with the agency? 2) What is the date of the program s pending application for accreditation and the date or approximate date when the agency s decision-making body is likely to decide whether to grant or deny accreditation for this program? 3) Does the agency accredit any other nursing education programs at this institution and, if so, are those programs in good standing with the agency? 4) Currently, what stages of the accreditation process has this program completed, and what stages remain to be completed? Please summarize the kinds of materials already submitted in support of the program s application and reviewed by the agency, as well as any on-site visits that have occurred. 5) Based on the agency records, what will be the start date or approximate start date of the program s academic year that immediately follows the expected graduation date for the students comprising the program s first entering class? 6) Based on the agency s review of each program to date, is there any reason to believe that the program will be unable to demonstrate compliance with the agency s standards and requirements and gain accreditation by the beginning of the academic year following the normal graduation date of students of the first entering class in such a program? If so, why? In addition, the letter from the recognized accrediting agency should state that the new educational program is an accrediting activity that falls within the scope of the Secretary s recognition and that the program will meet the accreditation/approval standards prior to the beginning of the academic year following the normal graduation date of students of the first entering class in such program. The applicant must have submitted not less than 30 days prior to the HRSA application due date, its request for a letter of assurance along with the accrediting agency letter and any supporting documentation regarding the accreditation or approval of the nursing program to the Accreditation Division staff at aslrecordsmanager@ed.gov. If you need additional information regarding the submission, you should contact Cathy Sheffield by telephone at (202) ; fax: (202) 219:7005; or at Cathy.Sheffield@ed.gov. The program will also submit its contact name(s), address(es), phone number(s), addresses, and the name of the HRSA Program with all correspondence sent to the Department of Education. The Accreditation Division will acknowledge receipt of the application by notifying the program by . If the application is not received timely, the acknowledgement letter will notify the program that the Accreditation Division will not process the request. HRSA

13 The Department of Education will process the applicant s request for a letter of reasonable assurance documenting the Secretary s determination that the program will meet the appropriate accreditation standards prior to the beginning of the academic year following the normal graduation date of students of the first entering class in such program. The applicant must include this letter of reasonable assurance (if applicable) from the Department of Education with the HRSA program application (Attachment 1). Applicants must provide documentation of all accreditation approvals (as defined in the Definitions Section of this funding opportunity announcement) needed to enroll students. Physician Assistant Accreditation Requirements Include eligibility documentation as instructed in Attachment 1. The applicant organization must provide a statement that they are accredited by ARC-PA and the dates of initial accreditation and next ARC-PA review. The full letter of accreditation is not required or encouraged. Awardees must immediately inform the HRSA project officer of any change in accreditation status. HRSA will confirm successful applicants accreditation annually throughout the award project period. An applicant must be an academically affiliated physician assistant education program accredited by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA). Academic affiliation is a formal relationship with an institution of higher education. New Physician Assistant Programs: A minimum of provisional accreditation is required. New programs that hold provisional accreditation by ARC-PA are eligible. An applicant with provisional accreditation must provide documentation in Attachment 1 indicating that continued accreditation is expected by fiscal year Cost Sharing/Matching Cost sharing/matching is not required for this program. 3. Other Applications that exceed the ceiling amount of $370,000 will be considered non-responsive and will not be considered for funding under this announcement. Any application that fails to satisfy the deadline requirements referenced in Section IV.3 will be considered non-responsive and will not be considered for funding under this announcement. Only institutions holding both nursing and physician assistant education program accreditation are eligible to apply. Any institution that fails to hold both accreditations will be deemed ineligible and will not be considered for funding under this announcement. HRSA

14 Maintenance of Effort: With respect to activities for which funds awarded under these titles are to be expended, the awardee must agree to maintain expenditures of non-federal amounts for such activities at a level that is not less than the level of such expenditures maintained by the entity for the fiscal year preceding the fiscal year for which the entity receives such an award. NOTE: Multiple applications from an organization are not allowable. An applicant organization can partner or affiliate with another applicant, but they may only serve as the primary applicant on one application. IV. Application and Submission Information 1. Address to Request Application Package Application Materials and Required Electronic Submission Information HRSA requires applicants for this funding opportunity announcement to apply electronically through Grants.gov. The registration and application process protects applicants against fraud and ensures that only authorized representatives from an organization can submit an application. Applicants are responsible for maintaining these registrations, which should be completed well in advance of submitting an application. All applicants must submit in this manner unless they obtain a written exemption from this requirement in advance by the Director of HRSA s Division of Grants Policy. Applicants must request an exemption in writing from DGPWaivers@hrsa.gov and provide details as to why they are technologically unable to submit electronically through the Grants.gov portal. If requesting a waiver, include the following in the request: the HRSA announcement number for which the organization is seeking relief, the organization s DUNS number, the name, address, and telephone number of the organization and the name and telephone number of the Project Director as well as the Grants.gov Tracking Number (GRANTXXXX) assigned to the submission along with a copy of the Rejected with Errors notification as received from Grants.gov. HRSA s Division of Grants Policy is the only office authorized to grant waivers. HRSA and its Digital Services Operation (DSO) will only accept paper applications from applicants that received prior written approval. However, the application must still be submitted by the deadline. Suggestion: submit application to Grants.gov at least two days before the deadline to allow for any unforeseen circumstances. IMPORTANT NOTICE: CCR moved to SAM Effective July 30, 2012 The Central Contractor Registration (CCR) transitioned to the System for Award Management (SAM) on July 30, For any registrations in process during the transition period, data submitted to CCR was migrated to SAM. If a record was scheduled to expire between July 16, 2012 and October 15, 2012, CCR extended the expiration date by 90 days. The registrant received an notification from CCR when the expiration date was extended. The registrant then will receive standard reminders to update their record based on the new expiration date. Those future notifications will come from SAM. HRSA

15 SAM will reduce the burden on those seeking to do business with the government. Vendors will be able to log into one system to manage their entity information in one record, with one expiration date, through one streamlined business process. Federal agencies will be able to look in one place for entity pre-award information. Everyone will have fewer passwords to remember and see the benefits of data reuse as information is entered into SAM once and reused throughout the system. Active SAM registration is a pre-requisite to the successful submission of grant applications! Items to consider are: When does the account expire? Does the organization need to complete the annual renewal of registration? Who is the ebiz POC? Is this person still with the organization? Does anything need to be updated? To learn more about SAM, please visit Note: SAM information must be updated at least every 12 months to remain active (for both awardees and sub-recipients). Grants.gov will reject submissions from applicants with expired registrations. Do not wait until the last minute to register in SAM. According to the SAM Quick Guide for Grantees ( an entity s registration will become active after 3-5 days. Therefore, check for active registration well before the application deadline. Applicants that fail to allow ample time to complete registration with SAM or Grants.gov will not be eligible for a deadline extension or waiver of the electronic submission requirement. All applicants are responsible for reading the instructions included in HRSA s Electronic Submission User Guide, available online at This Guide includes detailed application and submission instructions for both Grants.gov and HRSA s Electronic Handbooks. Pay particular attention to Sections 2 and 5 that provide detailed information on the competitive application and submission process. Applicants are also responsible for reading the Grants.gov Applicant User Guide, available online at This Guide includes detailed information about using the Grants.gov system and contains helpful hints for successful submission. Applicants must submit proposals according to the instructions in the Guide and in this Funding Opportunity Announcement in conjunction with Application Form SF-424 Research and Related (SF-424 R&R). The forms contain additional general information and instructions for applications, proposal narratives, and budgets. The forms and instructions may be obtained by: HRSA

16 1) Downloading from or 2) Contacting the HRSA Digital Services Operation (DSO) at Each funding opportunity contains a unique set of forms and only the specific forms package posted with an opportunity will be accepted. Specific instructions for preparing portions of the application that must accompany the SF-424 R&R appear in the Application Format Requirements section below. 2. Content and Form of Application Submission Application Format Requirements The total size of all uploaded files may not exceed the equivalent of 80 pages when printed by HRSA. The total file size may not exceed 10 MB. The 80-page limit includes the abstract, project and budget narratives, attachments, and letters of commitment and support. Standard forms are NOT included in the page limit. HRSA strongly urges applicants to print their application to ensure it does not exceed the 80-page limit. Do not reduce the size of the fonts or margins to save space. See the formatting instructions in Section 5 of the Electronic Submission User Guide referenced above. Applications must be complete, within the 80-page limit, within the 10 MB limit, and submitted prior to the deadline to be considered under this announcement. Application Format Applications for funding must consist of the following documents in the following order: HRSA

17 SF-424 R&R Table of Contents It is mandatory to follow the instructions provided in this section to ensure that your application can be printed efficiently and consistently for review. Failure to follow the instructions may make your application non-responsive. Non-responsive applications will not be considered under this funding opportunity announcement. For electronic submissions, applicants only have to number the electronic attachment pages sequentially, resetting the numbering for each attachment, i.e., start at page 1 for each attachment. Do not attempt to number standard OMB approved form pages. For electronic submissions no table of contents is required for the entire application. HRSA will construct an electronic table of contents in the order specified. Application Section Form Type Instruction HRSA/Program Guidelines SF-424 R&R Cover Page Form Pages 1 & 2 Not counted in the page limit. Pre-application Attachment Can be uploaded on page 2 of SF-424 R&R Not Applicable to HRSA; do not use. Box 20. SF-424 R&R Senior/Key Person Profile Form Supports 8 structured profiles (PD + 7 additional) Not counted in the page limit. Senior Key Personnel Biographical Sketches Senior Key Personnel Current and Pending Support Attachment Attachment Can be uploaded in SF-424 R&R Senior/Key Person Profile form. One per each senior/key person. The PD/PI biographical sketch should be the first biographical sketch. Up to 8 allowed. Can be uploaded in SF-424 R&R Senior/Key Person Profile form. Counted in the page limit. Not Applicable to HRSA; do not use. Additional Senior/Key Person Profiles Additional Senior Key Personnel Biographical Sketches Additional Senior Key Personnel Current and Pending Support Attachment Attachment Attachment Can be uploaded in SF-424 R&R Senior/Key Person Profile form. Single document with all additional profiles. Can be uploaded in the Senior/Key Person Profile form. Single document with all additional sketches. Can be uploaded in the Senior/Key Person Profile form. Project/ Performance Site Locations Form Supports primary and 29 additional sites in structured form. Counted in the page limit. Counted in the page limit. Not Applicable to HRSA; do not use. Not counted in the page limit. HRSA

18 Application Section Form Type Instruction HRSA/Program Guidelines Additional Performance Site Location(s) Attachment Can be uploaded in SF-424 R&R Performance Site Locations form. Single document with all additional site locations. Other Project Information Form Allows additional information and attachments. Project Summary/Abstract Attachment Can be uploaded in SF-424 R&R Other Project Information form, Box 6. Project Narrative Attachment Can be uploaded in SF-424 R&R Other Project Information form, Box 7. Bibliography & References Attachment Can be uploaded in Other Project Information form, Box 9. Facilities & Other Resources Attachment Can be uploaded in Other Project Information form, Box 10. Equipment Attachment Can be uploaded in Other Project Information form, Box 11. Other Attachments Attachment Can be uploaded in SF-424 R&R Other Project Information form, Box 12. Supports multiple. SF-424 R&R Budget Period (1-5) - Section A B Form Supports structured budget for up to 5 periods. Additional Senior Key Persons Attachment SF-424 R&R Budget Period (1-5) - Section A - B, End of Section A. One for each budget period. SF-424 R&R Budget Period (1-5) - Section C E Form Supports structured budget for up to 5 periods. Additional Equipment Attachment SF-424 R&R Budget Period (1-5) - Section C E, End of Section C. One for each budget period. Counted in the page limit. Not counted in the page limit. Required attachment. Counted in the page limit. Refer to Funding Opportunity Announcement for detailed instructions. Required attachment. Counted in the page limit. Refer to Funding Opportunity Announcement for detailed instructions. Provide table of contents specific to this document only as the first page. Table of contents is not counted in the page limit. Optional; Counted in the page limit. Optional; Counted in the page limit. Optional; Counted in the page limit. Not applicable to HRSA; do not use. Not counted in the page limit. Counted in the page limit. Not counted in the page limit. Counted in the page limit. HRSA

19 Application Section Form Type Instruction HRSA/Program Guidelines SF-424 R&R Budget Period (1-5) - Section F K Form Supports structured budget for up to 5 periods. Not counted in the page limit. SF-424 R&R Cumulative Budget Form Total cumulative budget Not counted in the page limit. Budget Justification Attachment Can be uploaded in SF-424 R&R Budget Period (1-5) - Section F - K form, Box K. Only one consolidated budget justification for the project period. SF-424 R&R Subaward Budget Form Supports up to 10 budget attachments. This form only contains the attachment list. Subaward Budget Attachment 1-10 SF-424B Assurances for Non- Construction Programs Disclosure of Lobbying Activities (SF-LLL) Extracted Form to be attached Can be uploaded in SF-424 R&R Subaward Budget form, Box 1 through 10. Extracted form to be attached from the SF-424R&R Subaward Budget form and used for each consortium/contractual/subaward budget as required by the program funding opportunity announcement. Supports up to 10. Required attachment. Counted in the page limit. Refer to Funding Opportunity Announcement for detailed instructions. Provide table of contents specific to this document only as the first page. Not counted in the page limit. Filename should be the name of the organization and unique. Not counted in the page limit. Form Assurances for the SF-424 R&R package. Not counted in the page limit. Form Form Supports Supports structured structured data data for for lobbying lobbying activities. activities. Not counted in in the page limit. Attachments Form Form Supports up to 15 numbered attachments. Not counted in the page limit. This form only contains the attachment list. Attachment 1-15 Attachment Can be uploaded in Attachments form Refer to the attachment table provided below for specific sequence. Counted in the page limit. HRSA

20 To ensure that attachments are organized and printed in a consistent manner, follow the order provided below. Note that these instructions may vary across programs. Evidence of Non-Profit status and invention related documents, if applicable, must be provided in the attachment form. Additional supporting documents, if applicable, can be provided using the available rows. Do not use the rows assigned to a specific purpose in the program funding opportunity announcement. Merge similar documents into a single document. Where several documents are expected in one attachment, ensure that a table of contents cover page is included specific to the attachment. Table of Contents page will not be counted in the page limit. Please use only the following characters when naming your attachments: A-Z, a-z, 0-9, underscore (_), hyphen (-), space, period, and limit the file name to 50 or fewer characters. Attachments that do not follow this rule may cause the entire application to be rejected or cause issues during processing. Attachment Attachment 1 Description Accreditation Documentation For Nursing programs: letter of accreditation, a copy of the certificate of accreditation; or letter from the United States Department of Education providing reasonable assurance of accreditation. Attachment 2 Attachment 3 Attachment 4 Attachment 5 Attachment 6 Attachment 7 Attachment 8 Attachment 9 Attachment 10 Attachments For PA programs: a statement of accreditation. Required; included in the page limit. Staffing Plan and Position Descriptions for Key Personnel. Required; included in the page limit. Letters of Support. Required; included in the page limit. Letters of Agreement/Commitment and/or Description(s) of Proposed/Existing Contracts (project specific). Required; included in the page limit. Organizational Chart. Required; included in the page limit. Biographical Sketches of Consultants. Required; included in the page limit. Institutional Diversity Statement. Required; included in the page limit. Maintenance of Effort Documentation. Required; included in the page limit. Funding Preference. As applicable; included in the page limit. Federal Debt Statement. As applicable; included in the page limit. Other attachments. As applicable; included in the page limit. HRSA

21 Application Format i. Application Face Page Complete Application Standard Form 424 Research and Related (SF-424 R&R) provided with the application package. Prepare according to instructions provided in the form itself. For information pertaining to the Catalog of Federal Domestic Assistance, the Catalog of Federal Domestic Assistance Number is DUNS Number All applicant organizations (and subrecipients of HRSA award funds) are required to have a Data Universal Numbering System (DUNS) number in order to apply for a grant or cooperative agreement from the Federal Government. The DUNS number is a unique nine-character identification number provided by the commercial company, Dun and Bradstreet. There is no charge to obtain a DUNS number. Information about obtaining a DUNS number can be found at or call Please include the DUNS number in item 5 on the application face page. Applications will not be reviewed without a DUNS number. Note: a missing or incorrect DUNS number is the number one reason for applications being Rejected for Errors by Grants.gov. HRSA will not extend the deadline for applications with a missing or incorrect DUNS number. Applicants should take care in entering the DUNS number in the application. Additionally, the applicant organization (and any subrecipient of HRSA award funds) is required to register annually with the System for Award Management (SAM) in order to conduct electronic business with the Federal Government. SAM registration must be maintained with current, accurate information at all times during which an entity has an active award or an application or plan under consideration by HRSA. It is extremely important to verify that the applicant organization SAM registration is active and your Marketing Partner ID Number (MPIN) is current. Information about registering with SAM can be found at Please see Section IV of this funding opportunity announcement for SAM registration requirements. ii. Table of Contents The application should be presented in the order of the Table of Contents provided earlier. Again, for electronic applications no table of contents is necessary as it will be generated by the system. (Note: the Table of Contents will not be counted in the page limit.) iii. Budget Complete the SF-424 Research & Related Budget form included with the application kit (Sections A-J and the Cumulative Budget) for each budget period. Upload the Budget Justification Narrative for the entire project period (all budget periods) in Section K of the Research & Related Budget Form. Following completion of Budget Period 1, you must click on the NEXT PERIOD button on the final page to allow for completion of Budget Period 2. You will repeat this instruction to complete Budget Periods 3, 4, and 5. The Cumulative Budget is automatically generated and provides the total budget information for the five-year grant request. Errors found in the Cumulative Budget must be corrected within the HRSA